Abstract

Objective: In the intensive care unit, we investigated the relationship between MPV (mean platelet volume), RDW (red cell width distribution), NLR (Neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio) markers to identify chronic inflammation between patients diagnosed with DKA, patients diagnosed with diabetes, and healthy volunteers.

Methods: Sixty-five patients with DM diagnosis were included in the study. Of these, 32 had DKA, 33 did not have any diabetes complications. Forty five completely healthy persons were included in the study. Healthy volunteers Group 1, Diabetes alone Group 2, DKA-recognized domains were defined as Group 3. The MPV, RDW, PLO, NLO values were obtained by performing a hemogram examination.

Results: The mean MPV of Group 1 was 6.6 ± 0.9 fl, Group 2 was 7.7 ± 0.7 and Group 3 was 8.6 ± 1.6. There was a significant difference between groups in terms of MPV (p < 0.001). Positive correlation between serum NLR and RDW, PCT, PLR, MPV, age, AST, ALT, Basophil, MCHC, MCV, Hgb, Wbc, Plt, Neutrophil values; There was a negative correlation between albumin, SPO₂, HCO₃, pH and GCS values. MPV values correlated with HCO₃, GKS, RDW, SPO₂, NLR and pH values.

Conclusion: Elevated levels of NLR, PLR, MPV and RDW in patients with DKA lying in intensive care unit ere potential showed the presence of the inflation and mortalities were increased in these patients.

Keywords: Diabetic Ketoacidosis; Hematological Parameters; ICU

References

1. Ma SG., et al. “Assessment of the platelet parameters and serum butyrylcholinesterase activity in type 1 diabetes patients with ketoacidosis”. Platelets7 (2013): 544-548.
2. Safari S., et al. “Can APACHE II Score Predict Diabetic Ketoacidosis in Hyperglycemic Patients Presenting to Emergency Department?” Anesthesia and Pain Medicine 4 (2014): e21365.
3. Misra S and N Oliver. “Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis”. Diabetic Medicine 1 (2015): 14-23.
4. Jindal S., et al. “Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications”. Hematology2 (2011): 86-89.
5. Das A and S Mukhopadhyay. “The evil axis of obesity, inflammation and type-2 diabetes”. Endocrine, Metabolic and Immune Disorders - Drug Targets (Formerly Current Drug Targets-Immune, Endocrine and Metabolic Disorders)1 (2011): 23-31.
6. Akbas M., et al. “The emerging role of Sirtuin1,-3 and-4 in glucose and lipid metabolism and in diabetes mellitus”. Journal of Molecular and Genetic Medicine 1 (2014): 1747-0862.
7. Agrawal NK and S Kant. “Targeting inflammation in diabetes: Newer therapeutic options”. World Journal of Diabetes 5 (2014): 697.
8. Twig G., et al. “White blood cells count and incidence of type 2 diabetes in young men”. Diabetes care (2012): 112298.
9. Vozarova B., et al. “High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes”. Diabetes2 (2002): 455-461.
10. Omu A., et al. “Butyrylcholinesterase activity in women with diabetes mellitus in pregnancy: correlation with antioxidant activity”. Journal of Obstetrics and Gynaecology 2 (2010): 122-126.
11. Tavil Y., et al. “Coronary heart disease is associated with mean platelet volume in type 2 diabetic patients”. Platelets5 (2010): 368-372.
12. Turkmen K., et al. “Platelet‐to‐lymphocyte ratio better predicts inflammation than neutrophil‐to‐lymphocyte ratio in end‐stage renal disease patients”. Hemodialysis International 3 (2013): 391-396.
13. Zhang Z., et al. “Platelet indices are novel predictors of hospital mortality in intensive care unit patients”. Journal of Critical Care 5 (2014): 885.
14. Kaya A., et al. “Relation of neutrophil to lymphocyte ratio with the presence and severity of stable coronary artery disease”. Clinical and Applied Thrombosis/Hemostasis 5 (2014): 473-477.
15. Akbas EM., et al. “Predictors of epicardial adipose tissue in patients with type 2 diabetes mellitus”. Diabetology and Metabolic Syndrome1 (2014): 55.
16. Kim JH., et al. “Response: clinical marker of platelet hyperreactivity in diabetes mellitus”. Diabetology and Metabolic Syndrome 2 (2014): 160-161.
17. Suslova TE., et al. “Platelet hemostasis in patients with metabolic syndrome and type 2 diabetes mellitus: cGMP-and NO-dependent mechanisms in the insulin-mediated platelet aggregation”. Frontiers in Physiology 5 (2015): 501.
18. El Haouari M and JA Rosado. “Platelet signalling abnormalities in patients with type 2 diabetes mellitus: a review”. Blood Cells, Molecules and Diseases 1 (2008): 119-123.
19. Yuri Gasparyan A., et al. “Mean platelet volume: a link between thrombosis and inflammation?” Current Pharmaceutical Design 1 (2011): 47-58.
20. Jabeen F., et al. “Role of platelet indices, glycemic control and hs-CRP in pathogenesis of vascular complications in type-2 diabetic patients”. Pakistan Journal of Biological Sciences 1 (2013): 152.
21. Lippi G., et al. “The mean platelet volume is significantly associated with higher glycated hemoglobin in a large population of unselected outpatients”. Primary Care Diabetes 3 (2015): 226-230.
22. Zuberi B., et al. “Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects”. Singapore Medical Journal 2 (2008): 114.
23. Ozder A and HH Eker. “Investigation of mean platelet volume in patients with type 2 diabetes mellitus and in subjects with impaired fasting glucose: a cost-effective tool in primary health care?” International Journal of Clinical and Experimental Medicine 8 (2014): 2292.
24. Zaccardi F., et al. “Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta‐analysis”. Diabetes/Metabolism Research and Reviews 4 (2015): 402-410.
25. Xiao W., et al. “Relationship between platelet volume indices with macrovascular and peripheral neuropathy complications in type 2 diabetic patients”. Journal of Diabetes 4 (2014): 298-303.
26. Erdoğan S., et al. “Liver enzymes, mean platelet volume, and red cell distribution width in gestational diabetes”. Turkish Journal Of Medical Sciences 1 (2014): 121-125.
27. Citirik M., et al. “MPV may reflect subcinical platelet activation in diabetic patients with and without diabetic retinopathy”. Eye 3 (2015): 376.
28. Akinsegun A., et al. “Mean platelet volume and platelet counts in type 2 diabetes: mellitus on treatment and non-diabetic mellitus controls in Lagos, Nigeria”. The Pan African Medical Journal (2014): 18.
29. Abbott C., et al. “Relationship between serum butyrylcholinesterase activity, hypertriglyceridaemia and insulin sensitivity in diabetes mellitus”. Clinical Science 1 (1993): 77-81.
30. Ma Sg., et al. “Increased serum levels of ischemia-modified albumin and C-reactive protein in type 1 diabetes patients with ketoacidosis”. Endocrine3 (2012): 570-576.
31. Stentz FB., et al. “Proinflammatory cytokines, markers of cardiovascular risks, oxidative stress, and lipid peroxidation in patients with hyperglycemic crises”. Diabetes 8 (2004): 2079-2086.